IF YOU’VE NEVER experienced a gout flare-up, understand that there’s absolutely nothing funny about it. The condition, a type of inflammatory arthritis, can feel like exactly that: flames. Shooting, burning, explosive pain—powerful and oftentimes sudden. People who suffer from gout usually feel this searing sensation in their big toe, but it can also set their ankles, knees, elbows, wrists, and fingers ablaze. An acute gout flare often starts at night and can last from 4 to 12 hours. Lingering discomfort can go on for a few weeks. Advanced cases involve bumps or nodules forming in the body, including under the skin and in the joints, and—on top of all that—kidney stones.
Late last year on his podcast, Bussin’ with the Boys, offensive tackle and three-time NFL Pro Bowler Taylor Lewan went public about a debilitating gout flare that left him “always in pain.” Lewan, 34, compared himself to the characters of 127 Hours and the Saw movies who cut off their own limbs to free themselves from danger. “I would rather tear my ACL and go through nine months of rehab again instead of having gout for a week,” , who did actually tear his ACL during a 2020 game.
Up until roughly a decade ago, plenty of people—doctors included—weren’t taking gout seriously, especially in young men. Maybe that’s because the condition, which has a history of affecting European royals, has long been known as “the disease of kings.” These regal men feasted on rich, expensive foods and drank plenty of alcohol, sometimes wearing their diagnosis as a high-society badge of honor. Basically: Gout was an old, rich dude’s problem.
Contrary to its image, though, gout can afflict people of all ages and royal statuses. Current estimates tally more than 6 million men and 3 million women suffering with gout in the U.S.—and the condition is on the rise in young men. Youth cases (that’s 10- to 24-year-olds) have surged more than 20 percent in recent decades, and projections indicate a 70 percent increase in global gout cases by 2050.
Not surprisingly, gout is trending online. TikTok and Instagram influencers—yes, gout influencers—share prevention and treatment strategies with their followers. On TikTok alone, popular videos on gout have collectively amassed more than 426 million views. Clips show youngish stand-up comedians with gout dunking on their condition. Reddit threads debate the nuances of medication. The supply of gout memes is seemingly infinite.
Granted, part of the uptick in cases is due to increased awareness: Doctors are becoming better at spotting and diagnosing gout. But other factors are at work—and scientists are still untangling the complexities of the condition. For people who suffer from gout, though, relief can’t come fast enough.
A Real Pain
FOR GARY HO, his decades-long health battle with gout began when he was 24. He was walking across his college campus and “my right ankle started to swell,” he says. “It was incredibly painful. It felt like I had broken my foot, but I hadn’t done anything.”
When Ho visited a doctor about his pain, the doctor dismissed it as overexertion. Ho’s father said the pain might be hereditary—he, too, had gout, and so did Ho’s grandfather. But gout, the doctor said, wasn’t a young man’s disease. “For 16 years,” says Ho, “I’d go through this cycle of handling the pain as much as I could, going to the doctor, repeating my story, and getting again told that I’m too young. I don’t meet the criteria. ‘It usually happens to older men. You’re too young to have gout.’ ”
It’s not as if being young lessens the pain, either. “It’s very dramatic in the majority of cases,” says Brian Mandell, MD, PhD, a rheumatologist with the Cleveland Clinic and a member of the Gout Education Society’s board of directors.
Gout’s signature pain is the result of sharp crystals shaped like tiny needles that form when a complex cellular process goes awry. Your body continuously produces uric acid when breaking down old cells or digesting foods that are high in purine, a water-soluble compound found in red meat, organ meat, and seafood.
For most people, their bloodstream and kidneys help clean up the uric acid and then they pee it out. But in gout sufferers, uric acid builds into those needle-sharp crystals, which tend to accumulate in the body’s extremities. While gout’s triggers vary, many sufferers report attacks after consuming alcohol (especially beer), tuna, scallops, steak, or juices that contain fructose—all of which are thought to increase uric acid.
Beyond the physically debilitating effects of gout, people who suffer from the condition say that it affects their relationships and mental health, too. Justin Radam, a Toronto barber, started having gout flares in his early 30s. While his daughter was learning to walk, Radam, now 40, was struggling with his own mobility. “I would be having a flare-up, and I’m lying there in bed with my foot elevated. That was one thing that would just kill me—being like, ‘No, baby, Dad can’t play with you right now.’ ”
When he was younger, Ho says he felt pressure to power through gout flares, even when doing so made him the butt of the joke. “I can still remember when I was hanging out with my boys in Austin in our younger days, going around listening to live music. At times I’d be on my crutches, or I’d hobble and try to keep up with them,” he says.
“They were trying to support me in the best way they could, but they would call me ‘gimpy’ or ‘gout boy.’ They thought it was endearing, but deep down inside, I’m like, Man, you don’t understand the thing. Like, if you tell me you have a migraine or your back is hurting, I would not be laughing.”
Like snoring or balding, gout has a reputation, at least among people who don’t have it, for being totally hilarious, which is bizarre considering how unfunny its symptoms are. Research on gout’s mental harms has found that gout patients can trivialize or conceal their diagnosis for fear of judgment, sometimes even being in denial about their symptoms.
Gout’s stigma “led patients to avoid seeking help from a general practitioner,” a 2025study found. In one survey of more than 1,000 gout patients, over a quarter reported that their self-esteem had taken a hit from suffering with the condition. Which is a full turn given that, at least historically, people with gout used to boast about having it.
“The Disease of Kings”
GOUT IS ONE of the oldest recognized diseases, first recorded by Egyptians in 2640 B.C.E.—and even early doctors saddled sufferers with a stigma. Greek physician Hippocrates wrote a guide to gout in the 5th century B.C.E., calling the condition the “unwalkable disease” and an “arthritis of the rich.” Only certain people contracted gout, Hippocrates theorized; unlike rheumatoid arthritis, which he perceived to plague the poor, gout hit the affluent.
Gout’s stereotype as “the disease of kings” endured in part because lots of royalty did have it. A 2025 study in the medical journal The Lancet Rheumatology found likely gout cases in the records of Spain’s Charles V, who developed it in his 20s. He shared this condition with his son Philip II, as well as England’s Henry VII, Henry VIII, Anne Stuart, and George IV. By the 9th century, the illness was something of a status symbol, immortalized in fables as an affliction of the idle nobility, whose lives were full of debauchery. To the less wealthy, gout was comeuppance for living large.
Today, pop culture often still treats gout as a sneaky fat joke. A 2021 study found that, in movies and TV shows set in the modern day, 79 percent of references to gout were intended to be funny. Gout has appeared in Game of Thrones, The X-Files, Friends, The Big Bang Theory, Everybody Hates Chris, The Jeffersons, and Seinfeld.
In a 1999 episode of King of the Hill, 12-year-old Bobby Hill contracts gout from eating too much liver. “My doctor says it’s very rare,” Bobby tells his class. “I’m the only kid under 70 to get this outside of the Gout Belt in the lower Balkans.” (If that joke were written today, Bobby might have several classmates with the condition.)
In the social media age, gout jokes run rampant on TikTok and Instagram. Self-deprecating comedians with gout collect laughs about how eating shrimp can cripple a man and how the condition most definitely does not make you feel like a king. (Commenters occasionally drop GIFs of that King of the Hill episode to comment.)
Comedian Steve Furey has worked gout into his stand-up routine, which he splices up for his social accounts. Furey, 37, began experiencing gout flares in his early 30s. His doctors also didn’t suspect gout at first, due to Furey’s age. Some of them even implied he was lying about his symptoms to get pain medication, he says. Others suggested his knee pain might be cancer. A biopsy later revealed the mysterious lump to be a golf ball–size uric acid deposit.
Furey says the humor of gout comes from the contrast between its reputation as an ailment of hard-partying kings and its reality as an everyman’s inconvenience. “It’s not a rich person’s disease,” he says. “It’s a dockworker’s disease. It’s a comedian’s disease.” Though Furey says he isn’t trying to be “the gout guy,” he’s heard from a ton of men on social media who are relieved to hear their condition discussed openly. “They finally feel seen,” he says.
The social media surge has elevated awareness about gout. (Because where else can you find people who look like you struggling with a condition that makes you feel isolated?) But experts are concerned that online gout communities are also spreading dangerous misinformation.
A Digital Disease
BECAUSE THIS IS 2026, you can, right now, find more than 170,000 posts tagged . Among the images of impossibly swollen toes and feet, you’ll discover a variety of recommendations for how to prevent and manage the condition, courtesy of white coat–wearing medical professionals, perfect-browed “wellness warriors,” and those haunting, AI-generated videos—many trying to sell you a supplement, detox formula, or other product you can conveniently purchase in the TikTok shop. “Would you like a complete, seven-day drink plan to prevent gout?” asks one robotic AI voice. “Write ‘yes’ in the comments and I’ll send it to you.”
For young people suffering with gout, it’s only natural that they’d hit up #gouttok for solutions. More than half of Gen Z respondents in a 2024 survey reported seeking health advice on TikTok, with a third describing TikTok as their primary source of health information. But when a New Zealand research team combed through TikTok’s top gout videos last year, they found that only 24 percent of the people talking about gout were health professionals. In fact, those 116 videos, which had earned a total of more than 426 million views at the time of the study, discussed gout management inaccurately. The main pieces of misinformation: that dietary fixes or herbal remedies can treat the condition.
Dietary changes are, at best, a partial solution. While you can eat a healthy diet, lose weight, and exercise regularly—and doing so may decrease the frequency and intensity of gout flare-ups—“doing those things does not mean that your gout is going to go away,” says Dr. Mandell, the Cleveland Clinic rheumatologist.
Herbal supplements, meanwhile, are bogus. Slicing ginger root and applying it to gouty joints, as one TikTok video recommends, will do nothing to stop a flare. Cherry juice, another popular TikTok remedy, might help lower urate levels, but not enough to help most people with gout, Dr. Mandell says: “The downside of taking those approaches is you’re basically still undertreating the disease itself.” And if you’re undertreating the disease, you run the risk of it getting worse.
Real Relief
DESPITE GOUT’S LONG history, scientists and doctors are still trying to determine what causes it, how to prevent it, and how to treat it. One known constant is that gout requires professional medical care. That’s largely because treatment “gets complicated very quickly because of all the associated comorbidities,” says Dr. Mandell.
Researchers are linking gout’s rise in young people to increases in other health issues in that population, like obesity, diabetes, cardiovascular disorders, and metabolic syndrome. Insulin resistance, for one, is currently climbing steeply among adolescents, and scientists are studying the condition’s role in uric acid buildup. Sedentary lifestyles, also on the rise among adolescents, have been linked with gout, but this leads to a diagnostic vicious cycle: People with gout often want to be active, but they can’t hit the gym while dealing with flare-ups.
You could also blame gout’s increase on modern diets, which are heavier than ever in the foods thought to trigger flares. Researchers have found correlations between gout and fructose, the sweetener that’s frequently added to foods in the form of high-fructose corn syrup. Ultra-processed foods, like processed meats and fast food, have also been linked to gout. And the current focus on downing lots of protein may backfire for those predisposed to gout: People who eat a diet heavy in red meats and/or seafood are more likely to get the condition.
Then there’s booze. While Americans have been consuming less alcohol overall since at least the late 1930s, roughly 27 percent of guys ages 18 to 25 have reported binge drinking, and alcohol can trigger gout, with studies showing that beer and hard liquor are the primary culprits.
But then there are the mystifying cases, like William Haire, who was diagnosed at 39 and has been living with gout for six months. When he woke up with intense pain in his toe, he thought he was suffering a delayed reaction to hurting himself at the gym the day before.
It was the urgent care physician who diagnosed him with gout. “I was kind of surprised that I got it, because I eat pretty clean, I work out a bunch, and I don’t drink very often,” Haire says.
His family doesn’t have a history of the condition (he asked around), and he thought he was living a healthful lifestyle. He tried a medication to manage symptoms but stopped taking it and instead doubled down on dietary changes. “The seafood I did eat, I’ve cut out. I’m drinking even less than I was before, in terms of how often and how much.” He’s cautiously optimistic that his first and only flare-up will be his last, but also, who knows?
The good news is that while we wait for science to determine why gout happens, there are proven ways to treat the condition’s symptoms. Some prescription drugs provide an intervention for gout flares by blocking white blood cells from mingling with uric acid crystals, reducing pain and inflammation during gout attacks.
One of them, colchicine, can be taken either in small doses for long periods of time to prevent severe attacks or in larger doses when an attack occurs. Other medications, like allopurinol, are prescribed for long-term daily use and help manage crystal buildups by limiting the body’s uric acid production. People who begin taking allopurinol are often also prescribed colchicine for the first few months.
With medication and moderation, Furey, the comedian, has been able to find long-term relief. “I can still go out to my friend’s birthday and have some cocktails and feel pretty good and have a steak that night. You just can’t do that very often.”
People with gout can ID and cut back on the foods that cause their flare-ups. Gout specialists sometimes recommend the Mediterranean and DASH diets for their low-purine, anti-inflammatory properties. But food isn’t the full story. A cocktail and a steak might not trigger a flare-up in one person, but could cause agony in another.
Weight is another factor, and doctors have also begun eyeing GLP-1 weight-loss drugs for gout treatment. The drugs have proved a powerhouse in fighting obesity and a suite of associated conditions, some of which are comorbidities of gout. Complicating that picture, however, are recent studies suggesting that GLP-1 users might face a slightly higher gout risk—a possible side effect of rapid weight loss.
And then there’s the fact that some missing elements in the gout equation might be hiding in our DNA, waiting to be triggered by external factors. “There are multiple factors that go into who is going to develop gout flares, who is going to have elevations in their blood level of uric acid,” Dr. Mandell says. “It’s in part a genetic disease.” While some people’s kidneys might excrete uric acid with ease, others’ kidneys might struggle. Genetics may even play a role in uric acid sensitivity.
The whole DNA debate helps explain the king thing. The previously mentioned Rheumatology study of monarchs with gout found that the disease passed from heir to heir. “Surprisingly, society (and medicine) chose to attribute gout to poor diet and alcohol when…the first demonstration that gout is a genetic disease was there in plain sight,” the researchers wrote. “The ‘disease of kings’ was not inherited by titles and wealth, but by genes.”
Like Ho, Radam also learned he had a family tree stricken with gout. “I’m of Filipino descent, and it’s very common among Filipinos,” he says. (Research has shown that Asians are three times more likely to have a gout diagnosis than Caucasians.) His dad gets gout flares. Among his Filipino community, Radam says gout can feel “almost like a given. You can joke about it, but it’s gonna be true for a large percentage of the guys and some of the women.”
At this point, the usual advice would be to ask your relatives if they have a history of gout. But given that large portions of the population might have lived with gout for years and not received a proper diagnosis, that conversation could be tricky. And that’s why some people who suffer from gout are turning to another source of understanding and support: IRL meetups.
Treating the Stigma
AT 40, HO finally saw a rheumatologist who diagnosed him with gout. A simple blood test revealed his uric acid levels to be dangerously elevated, and through dietary changes, exercise, medication, and regular check-ins with a gout specialist, he says, he has his condition under control and is back to an active lifestyle.
Ho says his years of unnecessary pain weighed on him. He knew other people were still undiagnosed and living out the nightmare of gout. Seeking to form a support group, he and his rheumatologist placed a newspaper ad for a Saturday morning gout meetup in Austin.
“We had five couples show up,” Ho says. “It was five wives dragging their husbands to a Saturday morning meeting to talk about gout. And they were grumpy. They were so grumpy.” But over coffee and doughnuts, everyone began opening up. “We started talking about pain and what we go through. And we bonded that morning. We bonded, and after that meeting, I thought, This is it. This is what has been missing.”
Though only five guys attended Ho’s first gout support meetup in 2015, the network soon grew, going online later that year and obtaining nonprofit status in 2021. Today it’s the Gout Support Group of America, a social and educational hub with more than 17,000 members. Participants won’t find miracle cures in the group, Ho says. Gout is a lifelong condition. But they’ll find answers—hopefully, faster than Ho did after his first flare-ups.
“I want to share that there is genuine hope for those living with gout that they can regain their quality of life,” he says. “They can regain their quality of life, be happy, be normal, eat whatever they want in moderation, and not live in fear.”
And people of all ages are welcome.